?Human beings are at the centre of concerns for sustainable
development. They are entitled to a healthy and productive life
in harmony with nature? ? Principle 1 of the Rio Declaration on
Environment and Development, 1992
This position statement and submission is delivered in response to the request for input from the co-chairs of
the UNCSD Bureau, dated 14 March 2011, to the compilation document used to prepare the zero draft of the
UNCSD Rio+20 outcome framework.

Preamble

The International Federation of Medical Students' Associations (IFMSA) represents 1.3 million medical
students from 91 countries across the globe.

We affirm our commitment to the principles outlined in the 1992 Rio Declaration on Environment and
Development, and of Agenda 21. In particular, we believe that human health and wellbeing must be a central
tenant of any global agreement made at the UNCSD Rio+20.

Whilst acknowledging the considerable improvements achieved in development and poverty eradication (in
no small part as a result of the Millennium Declaration), we note the limited progress made in bringing
together historically independent social, environmental and economic policy at a national and international
level.

Rio+20 must support global recognition that social, economic and environmental principles underpinning
sustainable development are mutually enhancing, not mutually exclusive. Evidence and experience have
proven that health and sustainable development are interdependent and indivisible. Progress thus far in
sustainable development has been impeded by constrained thinking, which assumes that economic growth
coupled with a focus on specific disease and discrete sectors in isolation to one another, will stimulate
development.

Objectives from Rio+20

We call for a return to the principles of health and human rights as enshrined in Article 1 of the 1992 Rio
Declaration and of health as the highest social goal as enshrined in the 1978 Declaration of Alma-Mata. This
should place health at the centre of the international negotiation process, as a necessary precondition for
sustainable development, fundamental to social, environmental and economic development. Such an
approach must address the social, environmental and economic determinants of health as a means to reduce
health inequities through integration of health in all outcomes of the summit.
Shifts in a geopolitical world have exacerbated many of the challenges faced by Majority World Nations. Chief
among them are the provision of access to medicines, health services, adequate food and clean water for
drinking and sanitation. We look to Rio+20 to elevate and further validate the social determinants of health
nexus as a core concept in sustainable development.
Rio+20 must provide a comprehensive and ambitious plan of action for the mainstreaming, enhancement, and
accelerated implementation of Agenda 21. Such strategies should include formal mechanisms to ensure the
co-implementation of social, economic and environmental policies and the securing of resources for
development and implementation of Action Plans.

Health in the Green Economy

We view the green economy as a means to achieving the overarching goals of global poverty eradication and
improved health and well-being for all, and not an end in itself.
We support the initiatives and strategies outlined in the World Health Organisation?s ?Health in the Green
Economy? Series1 which proposes a series of co-beneficial solutions for health and climate change mitigation
and adaptation, relating to health systems, housing and household energy, and the transport sector.
We call for a Health in All Policies (HiAP)2 approach to sustainable development, which outlines the need for
cooperation between all sectors of society, to advance human development, sustainability, and equity. Such
an approach emphasise that all implementation strategies which emerge from Rio+20 will be best achieved
when integrated with health and well-being as a key component of their policy development.
A key factor in the green economy must involve strengthening the capacity of national healthcare systems
with an emphasis on devolved yet integrated care, and embedded prevention thinking to face the emerging
epidemiological and demographic challenges in health. Such an approach will coincide with the development
and implementation of sustainable practices within healthcare systems.

The promotion of holistic and long-term sustainable city planning based on environment-sensitive master
planning that takes into account population growth, resource utilization, building design, efficient
transportation and waste management. Sustainable architecture should strive to improve living conditions,
reduce vulnerability and diminish exposure to hazardous materials, tackling the social determinants of health.
This could be made possible through financial incentives and mandatory technical standards for new
developments.
The implementation of environmental policies must stress green strategies which enhance health and
economic benefits in an equitable fashion, rather than environmental protectionist strategies, concerned only
with environmental benefit.

Youth Engagement and Capacity Building

Article 25 of Agenda 21 states that "Youth comprise nearly 30 per cent of the world's population. The
involvement of today's youth in environment and development decision-making and in the implementation of
programmes is critical to the long-term success of Agenda 21." We agree with the sentiment expressed in
Article 25 and call upon all parties to engage youth organisations and in particular young professional
organisations, with sustainable development decision making processes. As future health professionals who
will be involved in the delivery of healthcare and as young people whose health will be affected by failing to
develop sustainably we request all parties to listen to the views of future health professionals on sustainable
development.
With regards to capacity building, we take the concepts outlined in Article 6 of the UNFCCC and would like to
see them applied to the field of sustainable development. We call on parties to further ?the development and
implementation of education and training programmes, including the strengthening of national institutions
and the exchange or secondment of personnel to train experts in this field in particular for developing
countries?. We would also like to see this incorporated within existing professional education programs so as
to enable future professionals to actively participate in tackling sustainable development problems and
promoting of their solutions.
Implementation, Accountability, and Building Momentum
We support the use of key health-based indicators as a measure of global progress, and in the evaluation of all
sustainable development policies implemented as a result of Rio+20. Unlike sustainable development, health
is a simplistic and tangible concept, with immediate and personal benefits. As such, health outcomes generate
significant public interest and additional political will.

We look to the World Health Organisation, and their established tools and instruments useful in evaluating the
social impacts of policies across all sectors. Member states should implement similar evaluation and
monitoring mechanisms to obtain specific data on the effectiveness of the policy agreements made at the
Earth Summits, feeding back to regional reporting and support systems to ensure enhanced political
Accountability.

Whilst broadly supportive of proposals to upgrade the UNEP to a Specialised Agency, in that it would advance
the sustainable development agenda, we believe the integration and strengthening of health and human
rights institutions to tackle issues in sustainable development to be of equal importance. As such, any
additional Specialised Agency should include the economic, social and environmental principles of sustainable
development in its mandate.

We support an evidence based, precautionary approach to sustainable development detached from the biases
of the political process. As such, we see great merit in the establishment of an intergovernmental scientific
body tasked with reviewing and assessing the scientific, technical, and socio-economic information relevant to
sustainable development. Such a body would simultaneously act to form a link between policy- and decision-
makers, and sustainable development science.